If you are a social worker, counselor, doctor, agency, organization, clinic or private practice referring a patient for mental health, domestic violence, or maternal mental health counseling:
Step 1: Please complete the referral form in its entirety.
Step 2: Have patient sign release form below, scan and email both forms to
The patient will be contacted within two (2) regular business days.
*JL Counseling does not provide medication management services or outpatient substance abuse treatment. We also do not determine custody or placement of children.*